Pearly Whites: How to keep your teeth and gums healthy

Though most of us know the basics of dental health, knowing doesn’t mean we always do what we should. We spoke to Director of Dentistry Dr. Xiufeng Bao at HarMoniCare Women and Children’s Hospital, and Medical Director Dr. Didi Liu at Arrail Dental Clinic, for tips on dental care for the whole family.

The Basics Dr. Bao and Dr. Liu advise parents to start brushing their baby’s teeth as soon as they start to show. But for children under age 2, do not use a toothbrush. Instead, parents should wrap a clean cloth around a finger, dip it in clean or salt water, and clean the surfaces of the teeth and gums. Parents can also use a baby tooth cleaner (baobao yachi qingjieqi, 宝宝牙齿清洁器), a small silicone device for cleaning teeth and gums, and is available at Mothercare for RMB 79.

Dr. Bao advises that the best time for children to use toothpaste is when they have learned how to spit. At around 2-3 years of age, children are generally ready to begin using a toothbrush and toothpaste. This doesn’t mean parents take a back seat, though. Dr. Liu says: “Most children younger than 6 or 7 cannot clean their teeth properly. Let a child brush their own teeth to start, but parents should brush again to be sure the teeth are properly cleaned.”

Do not brush horizontally along the teeth, as this can cause enamel loss. Instead, gently brush up and down with a circular motion, tooth by tooth, and making sure you cover the back of your teeth, too. Brush at least twice a day for at least three minutes at a time, and rinse your mouth with water after every meal. Use a toothbrush with soft bristles and a small head, which Dr. Liu recommends changing every three months. Toothbrushes harbor a lot of bacteria.

Finally, floss at least once a day, really getting the inside surfaces of each tooth. “A toothbrush only gets your mouth 60 to 70 percent clean. Flossing will get another 30 percent, and mouthwash will get the final 5 or 10 percent,” explains Dr. Liu.

Prevention Aside from daily brushing, flossing, and mouthwash, one of the most vital elements of good oral hygiene is regular dental checkups and cleanings. Children should first see a dentist at 12 months of age, and visits should occur every six months.

Sealants are an important component of children’s oral hygiene. Dental sealants are coatings painted on the surfaces of teeth that help prevent decay, and they last two to five years. “Children should get their first sealants around 4 years old,” says Dr. Bao. They can get their second sealants when their permanent molars grow in, around 6 years of age. Once permanent teeth and molars have all grown in, 11- and 12-year-olds can get their teeth sealed again.

Gums Preventing gum disease is crucial in maintaining dental health. One effective prevention is not smoking. “Smoking, even secondhand smoke, can cause periodontal disease,” says Dr. Liu. An infection that destroys gum tissue, periodontal disease can be prevented through active brushing and flossing of the teeth. It is contagious, however, and the doctor encourages caution when sharing food and utensils. Losing a few teeth to periodontal disease is not the worst that can happen. “Periodontal disease can cause stroke, heart disease, lung infections, and infections throughout the body,” explains Dr. Liu.

Gum health is also an important factor in pregnancy. Dr. Bao suggests, “It’s best to get a dental exam before you get pregnant.” It’s best to have healthy gums before conception, because bacteria that causes periodontal disease can be passed on from mother to fetus. Dr. Bao also advises getting adequate calcium intake, as calcium deficiency can occur during pregnancy.

Dr. Liu adds that no dental procedures should be done when a mother is in the first or final trimester of pregnancy. During the middle three months, cleanings and dental procedures can be done under a doctor’s recommendation. If you are pregnant and your gums are bleeding, don’t be alarmed; it could be due to hormonal changes. See a doctor if symptoms worsen.

Orthodontics Orthodontia is known for being uncomfortable for wearers and financially burdensome for parents, but addressing orthodontic problems like crowded teeth, overbites, or cross-bites early on can mean faster, less expensive treatments. Braces at HarMoniCare generally cost between RMB 20,000 and RMB 40,000; at Arrail, they start at around RMB 10,000. Prices at both clinics depend on the kind of braces applied and the extent of the problem. Arrail offers invisible removable braces called Invisalign for adults. Dr. Liu recommends that children get traditional bracket braces, since the invisible ones are easy to remove and lose. She reminds those with braces that they need to clean their teeth more often than usual; they might have decay or gum problems if they don’t brush their teeth after every meal.

The need for braces can be prevented from the onset. “Little kids [who]suck their thumbs or bite their fingers [can cause]the upper and lower rows of their teeth to move out,” says Dr. Bao. The same issue can develop if they aren’t drinking correctly from milk bottles and sippy cups.

Whitening Drinking coffee or soda, smoking, and the passage of time can all cause teeth to yellow. Fortunately, whitening treatments have never been easier to come by. Children, whose teeth are not fully developed, should not get their teeth whitened, but the procedure is safe for ages 18 and older. Whitening is not permanent, however; it lasts one to two years, after which teeth will become yellow again. Whitening can also cause teeth to become sensitive to hot or cold, though the sensitivity should subside after the initial stages of treatment. Both Arrail and HarmoniCare offer whitening options onsite and for at-home use. In-office treatment uses a strong gel and takes a few hours, while the at-home gel treatment is weaker and takes an hour every day for two to four weeks.

Wisdom Teeth Some consider the removal of wisdom teeth a rite of passage, but as Dr. Liu reminds: “Not all wisdom teeth need to be taken out, unless they are erupting in the wrong position, there are gum problems, or they are causing decay on neighboring teeth.” Arrail offers both local and general anesthesia for wisdom teeth removal, though simpler extractions of one or two teeth need only local anesthesia.

Dr. Liu recommends his patients to get their wisdom teeth removed on a Friday or at the start of a holiday, so they can rest for a few days. Though the mouth may be sore after the procedure, it’s important to keep brushing your teeth to keep the wounds clean.

As with most health matters, the best way to maintain healthy teeth and gums is prevention in the form of regular dental checkups, daily brushing, flossing and mouthwash. If you’ve lost your oral hygiene groove, use the opportunity to teach your kids, as well as develop good habits of your own.